Help! My baby’s belly button is abnormally long

Dear doctor,

My son is two years old and since he was born, he has had an abnormally long belly button protruding for about five centimetres. Is this something to worry about?
 
Peter Ng'ang'a

Dear Ngángá,
After delivery, a baby’s umbilical cord is clumped and cut, and the remaining stump usually falls off within a few days or weeks. The healing of this area leads to formation of an inwards-facing or an outside-facing umbilicus or navel (belly button), both of which are normal.

The only time to get concerned is if there is inflammation and pain at the site, which means that there is likely to be an infection or another cause of inflammation. 

This requires urgent medical attention.

Another concern is the presence of a hernia. This is a swelling that occurs when underlying organs push through a weakness in the muscle or tissue that holds it in, for example, when intestines protrude through a weakness in the abdominal wall so that in that area, they are lying just under the skin.

This bulge is more noticeable when the baby cries or strains in any way, and can usually be reduced or “returned”. Most umbilical hernias are harmless and reduce and disappear by themselves by the time the baby is five years old. However, if there is pain, the swelling is tight and cannot be reduced, or the baby starts vomiting, then an emergency surgical procedure is required. In addition, if the hernia remains beyond age five even though there are no symptoms, then it can be surgically corrected.

How can I abstain from masturbation because it's really causing harm to my normal life, especially my physical activities — I am always fatigued. I have also been experiencing speech problems as well as producing watery semen. What can I do to stop masturbating? I need to regain my confidence.
A.T

Dear A.T,
Masturbation is a common practice among both men and women though it is more common in men. Due to the hormones that are released (dopamine, serotonin, oxytocin, and testosterone), it has a pleasure and reward mechanism —  it relaxes the mind and also bonds a person with the experience.

This can make it become a coping mechanism, which can lead to addiction. Excessive masturbation and addiction can lead to low self-esteem (which can affect your confidence and speech), depression, shame and guilt, anti-social behaviour, unrealistic sexual expectations due to use of pornography, loss of productivity because of using up a lot of time watching pornography and/or masturbating, relationship problems and genital irritation. It can also lead to watching more “hard-core” pornography and may lead to engagement in sexually deviant behaviour in a bid to get new exciting ways to get sexual pleasure. For some people, it can interfere with normal sexual relations. 

To manage excessive masturbation, the first step is to acknowledge that it is a problem then make deliberate efforts to stop it. 

It is best to get an alternative way to use your energy like exercise, creative arts or participating in volunteer programmes. 

Avoid being alone and interact with other people. Delete all pornographic material from your devices, and if possible, install a software to prevent access to unwanted sites or one that notifies a trusted person which sites you are accessing. It is also beneficial to get psychological and social support.

Therapy includes stress management, identification of triggers, coping mechanisms, behavioural modification, learning to replace mental imagery and couple therapy.
Once you recover from negative psychological, social and behavioural effects of the habit, any physical effects will usually resolve without need for further intervention. 

Lately, I have noticed I am experiencing nervousness, that is, trembling of hands. Could this be due to the process of ageing, or could it be due to anxiety? Please enlighten on this.

Dear reader,
Trembling of the hands or hand tremors can develop due to many possible causes. These include being anxious, stress, too much caffeine, fatigue, low blood sugar, alcohol, smoking, some psychoactive drugs, excessive exercise, some medications, lack of vitamin B12, nerve disorders, brain injury, hormonal disorders, some genetic disorders, mercury poisoning and liver or kidney failure. Ageing can be associated with hand tremors due to muscle weakness or due to the presence of underlying conditions.

To manage this, you first need to visit a doctor for necessary tests to identify the cause of the tremors.

Rest as necessary, limit intake of caffeine and alcohol, avoid smoking and using stimulant drugs, avoid excessive exercise, and change any medications that may be causing the tremors. Practise relaxation techniques to calm down when stressed or anxious. Physical and occupational therapy can help to improve coordination, muscle strength and control. Any underlying conditions should also be treated.

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